Individual
SARA THERIAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1055 S HOUSTON AVE, TULSA, OK 74127-9043
(918) 921-3200
Mailing address
2325 S HARVARD AVE, TULSA, OK 74114-3300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
116331
OK
363L00000X
Nurse Practitioner
Primary
208823
OK
Other
Enumeration date
07/24/2019
Last updated
08/14/2022
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